Talking at Night: A Novel

Obsessive-compulsive disorder, or OCD, is a mental health condition that manifests in repetitive, ritualistic behaviors or compulsions that alleviate intrusive thoughts. While everyone experiences intrusive thoughts intermittently, OCD is characterized by intense, frequent bouts of unwanted thoughts that disrupt daily function and quality of life. There are four subsets of OCD: contamination, order, doubt, and aggression. Individuals with Order OCD have an intense desire for symmetry, order, and control. They may arrange objects in a precise order, count items or steps excessively, or adhere to strict regimens. Any disruptions to their orderly world can cause significant anxiety and anguish, and they may be unable to leave the house unless everything is in perfect order. In Talking at Night, the protagonist Rosie deals with Order and Doubt OCD. She obsessively counts steps, arranges her room in a specific order, ritualistically touches items repeatedly, “checking” behaviors. Although Rosie’s checking briefly alleviates her anxiety, the respite is fleeting, and obsessive thoughts quickly return, creating a vicious cycle resulting in hours spent practicing these actions every day. Rosie becomes locked in a cycle of compulsions, limiting her capacity to engage in typical activities like sleeping and participating in social activities. Daverley isn’t the first author to take on OCD in fiction. Author John Green, diagnosed with OCD himself, wrote Turtles All the Way Down, which chronicles a teenage girl’s experience with the disorder.

To diagnose OCD, individuals must undergo a comprehensive evaluation by a mental health professional that begins with a clinical interview intended to gather data on the frequency and intensity of symptoms. The mental health professional will determine how much the symptoms impact the individual’s life and if family history or environmental stressors are contributing factors. Although it is unclear what causes OCD, brain scans have shown brain circuit abnormalities in sufferers of OCD. Genetic and environmental factors can also play a role. As with Rosie’s experience, traumatic life events can exacerbate symptoms. Using the Diagnostic and Statistical Manual of Mental Disorders or DSM-5, the clinician will evaluate if the symptoms meet the criteria for diagnosis as well as rule out other disorders such as anxiety or depression. 

OCD is treatable with a combination of medication like serotonin reuptake inhibitors or SSRIs and cognitive-behavioral therapy. The medication helps manage symptoms, while CBT helps people address their intrusive thoughts and develop healthy coping strategies. However, OCD is a complex disorder, and each person’s experience is different. When Rosie’s therapist asks her why she touches things repeatedly before leaving a room, she says “nothing” will happen if she doesn’t, but “[…] I know it makes no difference. But that doesn’t stop me feeling like I have to do it” (336). There isn’t just one prescriptive path for treatment as each individual’s experiences and symptoms differ. Anyone experiencing OCD symptoms can seek treatment from a licensed, trained, experienced clinician—appropriate intervention and support can help individuals avoid OCD’s debilitating effects and experience healthy and fulfilling lives (OCD-UK | A national OCD charity, run by, and for people with lived experience of OCD. (n.d.). https://www.ocduk.org/).